Journal of Blood Medicine (Jun 2022)
ABO and Rh Antigen Distribution Among Pregnant Women in South Western Uganda
Abstract
Yona Mbalibulha,1 Bernard Natukunda,1 Okwi Andrew Livex,2 Sam Ononge,3 Joan N Kalyango,4 Isaac Kajja5 1Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pathology, College of Health Science, Makerere University, Kampala, Uganda; 3Department of Obstetrics & Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda; 4Director Clinical and Epidemiology Unit, School of Medicine, College of Health Science, Makerere University, Kampala, Uganda; 5Deputy Principal College of Health Sciences, Makerere University, Kampala, UgandaCorrespondence: Yona Mbalibulha, Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda, Tel +256 773018980, Email [email protected]; [email protected]: ABO and Rh are the major blood group systems in Transfusion Medicine, the ABO system based on two red cell antigens (A, B) while the Rh has about 50 antigens of which five are highly clinically significant (D, C, c, E, e). These vary among races and ethnic groups. Blood type phenotype incompatibility between mother and fetus may result in antigen mismatch, triggering alloimmunization, and thus causing hemolytic transfusion reaction (HTR), which results in hemolytic disease of fetus and newborn (HDFN). This study aimed to determine the frequencies of ABO and rhesus blood group antigen in the pregnant women in South Western Uganda.Methods: A cross-sectional study was carried out on 1369 pregnant women who were recruited and provided consent to participate during their regular antenatal visits between August 2020 and July 2021. Four milliliters (4mL) of EDTA-anti-coagulated blood samples were collected and ABO and Rh-blood grouping including Rh antigen screening was done using the agglutination technology comprised of glass beads and reagent contained in a column of the Ortho Biovue ID Micro Typing System (Ortho Clinical Diagnostics, New Jersey, USA). The Rh antigen phenotypes and frequencies were then determined.Results: There was percentage distribution of 99.8%, c 99.3%, D 94.3%, C 19.2% and E 15.9%, with Rh cDe/cDe (65.1%) being the most common phenotype followed by cDe/CDe (15%), cDe/cDE (10.8%) and cDE/cDE 0.1% least common. The ABO grouping frequency was obtained as O 49.4%, A 29.5%, B 17.0% and AB 4.1%, with D positivity at 94.3%.Discussion: Population genetic variations result in varied expressions of red cell antigens that may have clinical complications. Knowledge of the presence of these Rh antigen distributions and phenotype frequencies during pregnancy help in rational management of the pregnancy, alloimmunization and better approach to safe blood transfusion.Keywords: ABO, Rh antigens, Rh phenotypes, pregnant women, South Western Uganda
